East-west breast correction - submuscular placement with silicone implants. Is this a realistic goal? (Photos)

Thank you for your question. For east–west breasts, a breast augmentation with submuscular silicone implants can often enhance central fullness and bring the breasts closer together. However, the extent of centralization depends largely on your natural chest wall shape, breast tissue position, and skin elasticity, as implants cannot physically alter the position of the breast footprint on the chest wall. You will not need a breast lift because the nipple is already above the breast fold.

Dear Phenomenal672698,

I almost always place implants submuscular. It lowers the rate of capsular contracture significantly. In addition, it looks much more natural because the muscle provides covering over the implant so its not as round on the top. I've also noticed the implants drop less over time when they are protected under the muscle.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

I recommend a circumareola approach to remove excess skin medially and pull the nipple-areola complexes more centrally. The scar is completely around the areolas. If additional volume is desired then liposuction and fat transfers may be an option.

Best Wishes,

Gary Horndeski, M.D.

good result. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

. Your nipples are slightly lateral positioned and it would not make much sense to place them more central which will require scar around. Small implant will not change nipple position but it will give you a nice improvement. Good luck.

Doing a breast augmentation based on your post photos, by the way, did not see the wish photo you stated you posted?, Your anatomy precludes much improvement with surgery by inserting a larger implant it would only magnify the cleavage space the out point of the nipples and the lateral fullness of the breast. Best of virtual consult with for better explanation. Regards.

The shape of your breast is fine. There is no need for lift. You will always have nipples that diverge. This is normal.

Plastic surgeons cannot change the position of the breast on the chest wall, nor can they change the projection angle.
The projection angle or breast divergence will have a major impact on the appearance of your breast with the projection of the implants.
The divergent becomes amplified as the implant pushes the nipple outward.
You should have a really clear understanding of what this will look like.
You need to see lots of before and after pictures of previous patients who also had significant breast divergence or as you call it “East versus West”.
Overall, I think you have really attractive looking breast and augmenting them with more projection may really look odd and undesirable.
Well, I understand the desire of looking better recognize that breast divergence really hampers what augmentation outcomes look like.
It’s a really difficult Situation to work with.
The bigger, the implants, the more odd the outcome is.
In other words, the bigger, the implant the more the divergence is put on Display.
I would go as far as saying, you may want to skip implants or breast surgery all altogether.
I’m sure other plastic surgeons will have different opinions and will be much more optimistic about your outcome.
Make sure you know exactly what the outcome will look like by being shown before and after pictures of previous patients who have the same degree of breast divergent.
During consultations, bring pictures of yourself to use as a reference.
Schedule multiple consultations to find the best provider and to get a consistent consensus of what the best approach will be.
Having multiple consultations is time consuming and may involve financial expense.
Considering the impact of not making these decisions wisely spending the time and potential money for multiple consultations is a good investment in yourself.
During each consultation, ask each provider to open up their portfolio and show you their entire collection of previous patients who had similar breast characteristics to your own.
This is we’re having pictures of yourself is necessary.
Do not go by memory of what your breast look like.
If the surgeon can’t find examples of previous patients who had your level of breast divergence, then they don’t have enough experience to do your procedure.
This is really important.
If you find examples of patients who had the same breast divergence and you like the outcome, then you may want to consider going forward with surgery.
I do not think moving the nipple position towards the midline is going to be successful at all.
You either accept your breast divergence and recognize it will be amplified with the projection of the implants or don’t do the surgery.
In a nutshell, I think your breast simply look too great to be distorted with implants which leads to unnatural appearance on women who have your degree of breast divergence.
Best,
Mats Hagstrom MD